UK COVID-19 Daily: 'we are at the peak'

  • Tim Locke, Medscape.com

  • UK Medical News
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These are the UK coronavirus stories you need to know about Wednesday.

'We Are at the Peak' 

'Are we there yet?' has been a constant question over recent days.

On Wednesday, we had the answer: "We are at the peak," England's Health Secretary Matt Hancock told the Commons in a statement.

Though Foreign Secretary Dominic Raab later cautioned "we're not out of the woods yet", adding: "There's certainly light at the end of the tunnel, there is a glimmer, but we're not there yet." 

Parliament was back in business in a part virtual, part chamber-based sitting. Until now scrutiny of COVID-19 Government policy and progress had mostly been through reporters' questions at the Downing Street, Scottish Government, and Welsh Assembly news briefings.

Prime Minister's Questions was also back with Mr Raab standing in for the PM. 

It was also Sir Keir Starmer's first PMQs as Labour leader. "Testing is obviously crucial at every stage of the pandemic," he said. "But we have been very slow and we are way behind other European countries."

Mr Raab said there was now capacity for 40,000 tests a day towards the daily target of 100,000 by the end of the month, and the Government was "confident" of meeting its target.

However, Sir Keir stressed that only 18,000 tests a day are actually being carried out, pointing to long journeys to regional drive-in test sites as a disincentive for key workers to attend.

In his Commons statement, Mr Hancock said: "The tests are conducted in NHS hospitals, through our drive-through centres, mobile units, and home deliveries." 

He added: "And as we have reached the peak, and as we bring the number of new cases down, so we will introduce contact tracing at large scale."

This he said included a new NHS app that was in beta testing "working closely with some of the best digital and technological brains, renowned experts in clinical safety, and digital ethics, so we can get all of this right".

On procuring PPE supplies at home and abroad he said: "We have some of the best minds in the country working on this."

An RAF planeload of PPE from Turkey that was due at the weekend has now arrived.

Mr Hancock added: "This work is crucial so we can get our NHS and care staff the kit they need so they can do their job safely and with confidence."

Asked about PPE stocks, Government Chief Medical Adviser Professor Chris Whitty said: "We are still close to the line, but at a national level we're not 'underwater' on anything that I'm aware of. And I keep quite a close eye on this because I care very deeply about this, as do all members of my profession. But of course, there may be local issues." 

Chief of the Defence Staff Sir Nicholas Carter told the Downing Street briefing about the help the armed forces are giving: "In all of my more than 40 years of service this is the single greatest logistic challenge that I've come across," he said.

Mr Hancock said there are currently more than 3000 spare critical care beds. 

Overall, he said there are over 10,000 spare NHS beds and  "therefore we want to reopen the NHS to non-coronavirus symptoms".

Cancer Research UK warned on Wednesday that more than 2000 cancer cases are likely to be going undiagnosed every week due to coronavirus concerns.

Data and Deaths

Prof Whitty said new cases were "broadly flat with a slight trend downwards," but said we shouldn't expect "a sudden fall away of cases".

On people in hospital with COVID-19: "Looking across the country the situation is either improving, and I think it's pretty clearly improving for example in London, or broadly flat across all four nations." 

A rise in UK hospital COVID-19 deaths of 759 was reported on Wednesday taking the total to 18,100.

"The very steep upward climb that there was up to the earlier part of this month has now flattened off over the last week and a half," Prof Whitty said.

He cautioned that COVID-19 is "a global problem for the foreseeable future" and "this disease is not going to be eradicated. It is not going to disappear." 

Of the 665 deaths in English hospitals, patients were aged between 26 and 102. Of these 26 patients aged between 48 and 95 had no known underlying health condition.  

On Tuesday, weekly community and hospital deaths in England and Wales up to 10th April were reported by the Office for National Statistics. On Wednesday, National Records of Scotland produced its weekly report:

  • COVID-19 accounted for 34% of all deaths in week 16 (13th to 19th April).

  • 33% of COVID-19 deaths registered to date related to care homes, 56% of deaths were in hospitals, and 10% at home or non-institutional settings.

  • 74% of all deaths involving COVID-19 to date were in people aged 75 or over.

On Wednesday, the 'official' number for NHS worker deaths was said to be 69. That's at odds with Nursing Notes' estimate of more than 100 and HSJ's analysis of 119 deaths.
 
Among recently reported NHS deaths:

Former Cerne Abbas Surgery GP Dr Craig Wakeham, 59, died on Saturday. He worked as chief clinical information officer at Dorset Clinical Commissioning Group and was said by colleagues to be a “leading light” in his field, adding: "His legacy lives on in our patients who he cared for diligently, and in the good name he built for our surgery."

Josephine Peter worked as an agency nurse at Southport and Formby District General Hospital. Trust Chief Executive Trish Armstrong-Child said: "Josephine’s husband, Thabo, told me she was passionate, hardworking, always putting others before herself. She was ‘my heroine’, he said."

Mental health nurse Khulisani Nkala, 46, died on Friday. Dr Sara Munro, chief executive of Leeds and York Partnership NHS Foundation Trust, said he was "a well-respected and selfless professional nurse, who always put the patient first, and will be greatly missed by his colleagues."

In Memoriam: Healthcare Workers Who Have Died of COVID-19.

Mental Health Next 'Care Home Style Crisis'

There's been a big focus on care home deaths recently. Now mental health units are facing a similar crisis, the Royal College of Psychiatrists warns.

Results from 1685 responses to a member survey show:

  • 51% of psychiatrists could access tests for themselves

  • 61.3% in England could confirm they had access to correct PPE

College President Professor Wendy Burn said in a statement: "The findings of our survey are deeply worrying, with many psychiatrists unable to test their patients or themselves in line with official advice.

"Without access to testing kits and the right protective equipment, I fear we could see a care home-style crisis sweeping through mental health units, with many patients and staff contracting the virus."

More News in Brief

  • The UK's age range for self-isolation from 70 may be too high, research in the Journal of the Royal Society of Medicine suggested. It cited data showing case fatality rates for 60 to 69-year-olds in Italy are 3.5%, and 3.6% in China. France and Switzerland set their recommendations at 65. Prof Azeem Majeed, co-author with colleagues from Imperial College London and the University of Exeter, said: "The UK’s policy is at variance with the World Health Organisation, which states that those above the age of 60 years are at the highest risk, requiring additional preventative measures."

  • The latest rebuttal to critical press coverage comes from the Department of Health and Social Care over a Daily Mail story about London’s Nightingale Hospital.. "Several media reports running today about NHS Nightingale are misleading," it said in a blog post. "There is no shortage of nurses and all coronavirus patients who need treatment are being treated in existing London hospitals. NHS Nightingale's staffing model was always designed to be flexible based on demand across London."

  • The late Professor Stephen Hawking’s ventilator has been donated to the Royal Papworth Hospital in Cambridge. His family had already handed back NHS equipment used for his care at home. Now items he bought are being donated, "in the hope they will help in the fight against COVID-19," his daughter Lucy told The Gazette. “As a family, the NHS has always played a huge part in our lives."

Adapted from Medscape UK.